Renowned psychiatrist and psychological trauma expert Dr. Judith Herman was once posed a question on how to heal from psychological trauma. Her response, “the healing is relational — just as the damage is relational, the healing is relational. You can’t really heal by yourself.” Her point is this: we must engage socially if we are to combat our trauma. Exposure to childhood trauma is profound in our society. National data suggests 1 in 3 girls and 1 in 5 boys will survive child sexual abuse, and additional data reports 3.6 million referrals were made to child protective agencies across the United States. Clearly, childhood trauma is not a rare occurrence. And remember — these data are only reported incidents. Our knowledge of the prevalence of trauma is limited.
My job as a therapist allows me to see the devastating impact that psychological trauma creates — on both an individual and societal level. Exposure to psychological trauma is a factor in a number of psychological disorders, including Post Traumatic Stress Disorder (PTSD), substance use disorders, mood and anxiety disorders, personality disorders and psychotic disorders. More profound, however, is the impact that childhood trauma takes on survivor’s ability to navigate intimate relationships.
Avoidance as Survival
In my work as a therapist to trauma survivors, it’s become clear that individuals engage in a myriad of behaviors, both– adaptive and maladaptive — with one central purpose: to feel safe. Clients would not be engaging in potentially harmful behaviors if they felt they didn’t need to. An example of a maladaptive behavior focused on safety is intimacy avoidance.
Intimacy avoidance is manifested in a number of ways. These are a couple ways my clients have posed this to me:
· I was going on a date but I cancelled because I was so anxious
· I can’t even go on dating apps because I’m so nervous to put myself out there
· I don’t really find the necessity of a boyfriend. I’m fine by myself.
In these examples, we can see the fear that relationships bring — and in the last one, this person has chosen isolation rather than companionship. Understanding avoidance can be pretty simple — as all humans use this defense in a number of ways. Think of the age old example of a child touching a hot stove and getting burned. Once the child is hurt, the child learns that stoves can cause harm. Consequently, the child does not touch a hot stove again. The same principle is true for trauma survivors in relationships. When a child learns their primary relationships are untrustworthy and unsafe, the child quickly feels that all relationships are unsafe. Thus, much like a hot stove, the abused child does not touch relationships again. If the survivor does engage in relationships, they may be incredibly weary and anxious — always looking for signs of danger.
It’s understandable that intimacy avoidance yields safety. Adult survivors of child abuse may routinely avoid intimacy with others. It’s very possible that in the abusive environment, the child’s only defense mechanism was isolation. If one can relationally withdraw, one can be protected. Intimacy avoidance is adaptive in the traumatizing environment — and may be necessary. However, outside of the traumatizing environment, this avoidance invariably yields pain. Intimacy avoidance may provide immediate relief from pain, but this relief comes at a price — disconnection and loneliness.
Another prominent psychiatrist, Dr. Bessel van der Kolk, uses the comparison to a sensitive smoke detector. We’ve all lived in apartments where the smoke detector will sound the alarm even if we slightly burn toast. The smoke detectors scream and yell despite the minimal amount of danger we are in. The traumatized mind works similarly. In relationships, the survivor’s internal smoke detector is blaring, manifested by anxiety and our body’s flight, flight and freeze response. The old, archaic part of the brain, the limbic system, tells the survivor one thing: you are not safe and you need to run. Thus, survivors of child abuse then have a unique relationship challenge: engage in social and intimate relationships— which creates fear — or continuously feel disengaged, lonely and abandoned. Survivors are stuck between the biological and psychological need of attachment and the intolerable panic they feel in relationships. This is where therapy from a trained psychologist, counselor or clinical social worker can be helpful.
So… What do we do now?
Relationships are a source of difficulty for everyone — even more for survivors of abuse. Through exposures and well trained therapists, survivors can not only manage their relationship anxieties, but actually use their experiences to become a great partner. Once mastery of trauma occurs, survivor’s narratives can become an enormous source of power and strength — for themselves or others. Mastery of trauma occurs in social relationships — it cannot occur in isolation. The beginning step is to reach out to someone — a trusted person who will listen. This could be a friend, family member or a therapist. You don’t need to disclose everything all at once. You get to control how much this person knows and the extent of every detail. Build trust and vulnerability with people at your own pace. Maybe start off small — it’s not necessary to open the conversation with your trauma.
The world can be a safe place. Relationships can be transformative. The vulnerability you bring to relationships will be the genesis of your healing — and allow you to believe that there are safe people in this world.
Bret Nielson is a Licensed Clinical Social Worker in Illinois. He is a graduate of social work programs at the University of Pennsylvania and Utah State University. Bret owns a private practice helping adults, children and teens recover from traumatic disorders and traumatic grief.